Preconception Care Services Research Articles

Exploring the perception of and attitude towards preconception care service provision and utilisation in a South Western Nigerian community – A qualitative study

Background: Hospital-based, quantitative studies in Nigeria show low levels of knowledge and use of preconception care (PCC) services. This study explored the perception of and attitude towards PCC in a southwestern Nigerian community qualitatively.Data Source and Methods: Focus group discussions (FGDs) were held with 57 purposively selected adult women and men and key informant interviews (KIIs) with one female and one male community leader in Ibadan North Local Government Area, Oyo State, Nigeria in 2018. The FGDs and KIIs held within the community were digitally recorded, transcribed verbatim and analysed thematically.Results: Participants placed PCC in the context of marriage, describing its importance for addressing effects of adverse exposures on pregnancy and ensuring positive pregnancy outcomes.Conclusion: Barriers to PCC uptake mentioned included lack of awareness and prohibitive service costs. Expressing their willingness to use and promote PCC use, they stated the need to ensure PCC uptake through improved awareness at the community level.

Experience of Pregnant Mothers on Preconception Care Among Antenatal Care Attendants in Sendafa Town Public Health Facilities, Ethiopia, 2020

Preconception care is the provision of biomedical, behavioral, and social health interventions to women and couples before conception occurs. Today, there is already a global consensus to incorporate preconception care as one of the continuum of reproductive health services which could decrease 71% of unwanted pregnancies, thereby eliminating 22 million unplanned births, 25 million induced abortions, and 7 million miscarriages. It was assessed the experience of preconception care and associated factors among pregnant Women attending Antenatal care at public health facilities in Sendafa town, Ethiopia from January 01-February 30, 2020. A cross-sectional study design was employed among 617 pregnant women attending antenatal care in public healthcare facilities. A systematic random sampling technique was employed. Interviewer administered structured questionnaire was used. The data were analyzed by using SPSS version 20 and P<0.05 at 95% confidence interval was taken as a statistically significant association. The majority (525, 88.7%) of the women had poor knowledge and only 67 (11.3%) had good knowledge of preconception care services. Pregnant women who had partner support on preconception care service, previous history of abortion, and women diagnosed with anemia were significantly associated with the experience of preconception care services. An experience of pregnant mothers on preconception care services was low and the study found that the knowledge level of study participants on preconception care services was very poor. Health education should be given for all women in the reproductive age group on preconception care services and male involvement should be encouraged for the provision of partner support.

Perception and Level of Knowledge on Preconception Care Uptake Among Women of Child Bearing Age Attending Reproductive Health Clinic at Kenyatta National Hospital

Background: Provision of care to adolescent girls and women before and between pregnancies improves their overall health. It also improves the pregnancy outcomes and the health of the new-born. There are many health related conditions that have an impact on maternal and neonatal health. There is paucity of information regarding the uptake of pre-conception care and the effects thereof in regard to maternal and neonatal morbidity and mortality. The main aim of this study was to assess the Preconception Care (PCC) given to women of child bearing age at Kenyatta National Hospital Reproductive Health clinic. Methods: This was a descriptive prospective study that employed both qualitative and quantitative methods of data collection. The targeted population included the antenatal and postnatal women attended to at these clinics. Questionnaires were used to collect data from the respondents and the care providers were also interviewed. A total of 224 women of childbearing age who met the inclusion criteria were selected by convenient sampling technique and interviewed by use of questioners between December 2017 and March 2018. Content validity was ascertained by use of the test re-test method to establish reliability comparing with a Cronbach Alpha Reliability coefficient value. Data analysis was done by use of SPSS version 22; descriptive and inferential statistical tools like simple and multiple regressions were employed to establish association between the study variables and Chi square was used to establish if the association between independent and dependent variables were significant. Findings: Nineteen percent (19%, n=40) of the women knew about preconception care. There was positive attitude with 75.5% of the respondents stating that preconception care would improve the chances of having a healthy baby. Uptake was poor with only 23.1% had uptake of preconception care services despite the fact that 49.1% had received information on PCC. Conclusion: Women attending KNH reproductive clinic have –limited knowledge about PCC. Most of the women have positive attitude towards PCC but poor PCC practices.

The perspective of healthcare practitioners on preconception care at primary healthcare in Jakarta: A qualitative study

ObjectivesThis study has aimed at identifying the nature of preconception care delivered by healthcare practitioners toward prospective brides and grooms at primary healthcare in Jakarta. Materials and methodsThis study used a qualitative design with descriptive analysis. The participants of this study are nine health practitioners, who deliver preconception care to prospective brides and grooms at primary healthcare in Jakarta, involving doctors, nurses, midwives, health analysts, and psychologists. The criteria of the participant were healthcare practitioners who were in charge of delivering healthcare service to prospects from primary healthcare, at least having a year experience at primary healthcare, having at least an associate degree. Participants have selected through purposive sampling in which characteristics suitable to the research objectives. The trustworthiness of the data has met through principles of credibility, conformability, dependability, and transferability. ResultsThe study identified four themes, which include participants’ perspective on prospects preparation, implementation of preconception care to prospects at primary healthcare, obstacles faced during the delivery, and participants’ needs for preconception care services. ConclusionHealthcare practitioners need specialized training and interagency cooperation to enhance professional skill-mix in preconception care to achieve goals for maternal and child health.

Preconception care practices in Nigeria: a descriptive qualitative study

BackgroundPreconception care is a specialized care targeted at women of reproductive age before pregnancy to detect, treat or counsel them about pre-existing medical and social conditions that may militate against safe motherhood and positive pregnancy outcome. In spite of the known need for preconception care in Nigeria, routine preconception care services are not available in the country. This study explores existing preconception care practices in the country in order to encourage building on it and formalising it for inclusion in routine maternal and child health services in the country.MethodsForty-one in-depth interviews and 10 focus group discussions were conducted in this descriptive qualitative study to explore the existing preconception care services from the perspectives of community members (women and men in the reproductive age group), community and religious leaders, health care professionals as well as policy makers. Thematic analysis was carried out using MAXQDA 2018.ResultsParticipants stated that there are no defined preconception care services in the health care system nor are there any structures or guidelines for preconception care in the country. Preconception care services are however provided when health workers perceive a need or when clients demand for it. The services provided include health information, education and counselling, treatment modification, medical check-up and screening. Outside of the health system, there are some traditional, religious and other practices with similar bearing to preconception care which the participants believed could be included as preconception care services. These include premarital counselling services by religious bodies, family life and HIV education within the secondary school system and some screening and outreach services provided by non-governmental and some governmental agencies.ConclusionThere is a need to provide structure and guidelines for preconception care services in the country so that the services can be properly streamlined. This structure can also involve practices that are currently not within the health system.

Preconception care to improve pregnancy outcomes: clinical practice guidelines

Introduction: There is scientific evidence that the health of women before pregnancy contributes to the maternal and infant outcomes of pregnancy. There is also scientific evidence that the health of women of reproductive age may be improved through the provision of Preconception Care (PCC). Preconception care includes interventions to assess, identify, address, and modify a woman’s health conditions and risks to ensure that these health conditions and risks do not negatively affect the outcome of her pregnancy. Many of the medical conditions, environmental exposures, personal behaviors, and psychosocial risks associated with negative pregnancy outcomes have been identified and there are recommendations for including these conditions in PCC services. Objective: Our purpose is to present a tool for clinical care providers involved in delivering PCC services. We try to answer the following questions: what do providers actually do when a woman of reproductive age arrives at their offices? What questions to ask? What examinations to conduct? What laboratory tests to perform? And, what education and counselling to offer? Methods: We reviewed published and un-published literature related to the scientific evidence for the effectiveness of PCC in improving pregnancy outcomes. We searched PubMed for published articles, and we searched the internet for unpublished reports prepared by international organizations such as the World Health Organization and reports from governmental agencies. We summarized the information and presented a comprehensive overview of actions that providers should take to address various risk behaviors, exposures and health conditions. Results: Several scientists, countries, and international organizations have proposed answers to the above questions. However, there has been no consistency and there is not a single publication that includes a comprehensive compilation of the proposed actions. We summarized the recommended actions that clinical care providers should take in addressing various health conditions, risk behaviors, and exposures. Conclusion: It is recommended that all providers screen all women for their intentions to become pregnant and to provide them with appropriate services. Women should be referred to specialized care when risk behaviors and medical conditions that go beyond the skills and abilities of the primary care provider are identified.

Patient Screenings for Preconception Health Interventions at a Community Pharmacy.

Preconception health refers to health before pregnancy and involves addressing risk factors that can negatively impact either a patient or future pregnancy. Pharmacists can play an essential role in screening for and managing patients’ risk factors to optimize pregnancy outcomes. The primary objective of this study is to determine whether preconception health screenings in community pharmacy settings identify opportunities for preconception health services, particularly pharmacy-based interventions. The secondary objectives are to describe the preconception health status of community pharmacy patients and their interest in receiving preconception care services by a clinical pharmacist in a community pharmacy setting. Two independent pharmacies conducted a pilot project where people were invited to complete a health screening form that evaluated their preconception health. Participants received a personalized health report with an invitation to meet with the clinical pharmacist for services related to identified opportunities, such as contraception and immunizations. Retrospective analysis was conducted for data collected from 43 women during the patient screening effort in three community pharmacy settings (two independent community pharmacy locations and one neighborhood pharmacy outreach event). Nearly all participants (n = 42, 98%) had at least one opportunity identified to receive preconception care services, with the majority related to their alcohol use (60%). A majority of participants (56%) indicated an interest in learning more about preconception services offered at the pharmacy, but only 19% wanted to schedule an appointment with a pharmacist. Thus, there is an apparent need and opportunity for utilization of preconception health services at the pharmacy.

A Nurse-Led Initiative to Improve Implementation of HIV Preconception Care Services.

United States guidelines recommend preconception care (PCC) as an integral part of primary care to improve maternal and fetal/newborn outcomes and promote planned pregnancies. Persons living with HIV have additional, specialized needs for PCC. However, PCC is not reliably integrated in HIV care, and few studies have examined strategies to improve the provision of PCC services. We describe a successful, nurse-led initiative that incorporated collaborative strategic planning in conjunction with staff education and continuous quality improvement to strengthen implementation of PCC in a small urban HIV care clinic. Key features of this project included consensus building, training, and action planning with clinic staff; addressing clinic-specific barriers; and providing ongoing support/technical assistance. Continuous quality improvement reviews at 12, 18, and 36 months demonstrated improved and sustained implementation of PCC services for women and men. Our experiences serve as a model for HIV primary care clinics working to advance implementation of PCC services.

Preconception care from a public health perspective

Abstract Public health researchers and practitioners are committed to developing, implementing and supporting initiatives that improve the health of the population. This presentation will provide an overview of the alignment between public health and preconception health. It will also overview ideas, theories and models that are central to the contemporary understanding of preconception health, such as epigenetics, the diverse preconception health behaviours and exposures that impact on outcomes, and the known barriers affecting the delivery of preconception care services. The presentation will draw on the principles of health promotion, health services research and epidemiology to provide a high-level understanding of the levers underpinning effective preconception health interventions at a policy, health services and grass-roots level.

PRECONCEPTION CARE: AWARENESS, KNOWLEDGE, ATTITUDE AND PRACTICE OF PREGNANT WOMEN, TAMALE WEST HOSPITAL

Purpose: The aim was to assess the awareness, attitude, knowledge level and practice of pregnant women on preconception care at the Tamale West Hospital Antenatal clinic in the Northern region of Ghana.Methodology: This study used a descriptive cross-sectional design with a quantitative approach. A quota sampling procedure was used to arrive at 200 participants. The starting point was randomly selected and a systematic random sampling method was used to select the study participants. Simple random sampling using the lottery approach was used to select the participants for the study. The target population was women (literate and illiterate) within the age range of 16 and 40 years attending the Tamale West Hospital for antenatal care. The list of all the women who fell within the target population was obtained from the register of the unit. The inclusion criteria were pregnant women who visited the Tamale West Hospital within a month’s duration for antenatal care services. A semi-structured questionnaire which had both open-ended and close-ended questions was used to generate the data. Descriptive statistics which involves frequencies and percentages was used to represent both independent and dependent variables of the study. Close-ended responses were inputted using the Microsoft Office Excel 2016. Open-ended responses were compiled in relation to the objectives of the study. Other relevant outcomes were cross-tabulated using SPSS version 21.Results: Though 20.0% of the pregnant women had positive attitude towards preconception care, only 34.5% were aware of preconception care and 42.5% and 23.5% had poor and high knowledge levels on preconception care respectively. When the age group was cross-tabulated with awareness, the results showed no statistical significance between the two variables (χ2=9.1; p=0.58). However, there was an association between the educational status (Tertiary level) (χ2=49.6; p=0.01) and religious affiliation (Muslim) (χ2=43.3; p=0.01) of the respondents on awareness. Educational status (Tertiary level) (χ2=45.4; p=0.01) and religion (χ2=21.3; p=0.01) were found to influence knowledge statistically. In terms of overall attitude, only Muslim (χ2=4.12; p=0.04) statistically impacted on the study.Conclusion: Pregnant women who attend Antenatal clinic at Tamale West Hospital tended to have low level of awareness and poor knowledge, they have negative attitude towards preconception care services and seldom practice preconception care. There is the need for health care authorities to intensify awareness and implement preconception care policies.Recommendation: The present study demonstrated that there was a need to create awareness which can also increase the knowledge and practices of reproductive age women or couples. Hence, there is the need for health authorities to put together comprehensive preconception care policies for health institutions to abide by.

Exploratory study of clinician and patient views regarding the use of a preconception care app for women with diabetes.

Women with diabetes are at increased risk of adverse maternal and foetal outcomes. Preconception care can minimise risk of complications and improve outcomes, but current provision is inadequate. Electronic health technology, particularly apps, could improve preconception care provision but research is lacking in this area. The aim of this article is to explore the views and experiences of clinicians and women with diabetes regarding the use of a mobile app for preconception care. An exploratory study was conducted. Data were collected using focus group and interviews with 19 participants, comprising 10 clinicians and 9 women with type 1 or 2 diabetes. Data were analysed thematically. Women with diabetes and clinicians highlighted the inadequacy and challenges of current preconception care service provision and expressed a high level of enthusiasm and interest, towards a preconception care app that could support preconception care delivery for women with diabetes and overcome barriers to preconception care service provision and uptake. The acceptability of mobile health technology to both women and clinicians creates an important opportunity to overcome existing barriers to service provision, delivery and uptake, and improve both maternal and foetal outcomes for women with diabetes.

Mothers\u2019 utilization and associated factors in preconception care in northern Ethiopia: a community based cross sectional study

BackgroundAdverse pregnancy outcomes remain a prevalent health problem in Ethiopia. Mothers’ use of preconception care service has the potential to avert many of the adverse outcomes. However, the use of this service and its determinants is not well investigated. Therefore, this study was conducted to assess the utilization and determinants of preconception care among recently delivered mothers.MethodsA community based cross-sectional design was conducted among 564 recently delivered mothers in Mekelle City, Northern Ethiopia. A multi stage cluster sampling technique was employed. Data was collected using a pre-tested, structured interviewer questionnaire and was entered in to Epi-Info™ Version 7 and analyzed using SPSS™ Version 20.0. Descriptive, bivariable and multivariable logistic regression was used to identify the association.ResultsThis study revealed that, 102(18.2%) of the mothers had utilized preconception care. Mothers’ knowledge on preconception care (AOR: 2.21; 95% CI: 1.03, 4.73), prior experience of adverse birth outcomes (AOR: 5.10; 95% CI: 2.31, 11.24), history of chronic health problems (AOR: 5.69; 95% CI: 2.06, 15.72), husband’s support (AOR: 13.84; 95% CI: 6.02, 31.79), and challenges in accessing a health facility (AOR: 0.24; 95% CI: 0.16, 0.48) were significantly associated with preconception care service utilization.ConclusionMothers’ utilization of preconception care is low. Mothers knowledge on preconception care, experience of adverse birth outcome, having chronic health problems and husband support increases utilization of preconception care. However, mothers who experienced challenges in visiting a health facility showed decrease preconception care utilization. Therefore, increased efforts are need in terms of advocating for involvement of husband’s and awareness creation respecting preconception care services for all women.

Utilization of preconception care and associated factors among reproductive age group women in Debre Birhan town, North Shewa, Ethiopia

BackgroundPreconception care refers to things women can do before and between pregnancies to increase the chance of having a healthy baby and being a healthy mother. Unfortunately, millions of women in the world do not have access to pre-pregnancy, pregnancy health services and childbirth with suitable quality. Therefore, addressing this significant gap and coming up with the necessary information is helpful to improve maternal and child health in our country. So, this study was aimed to assess the utilization of preconception care and associated factors among reproductive age group women in Debre Birhan Town, North Shewa, Ethiopia.MethodsA mixed method of community based cross-sectional study was employed from March 1st to 30; 2017. Systematic sampling technique was used to select a total of 424 reproductive age women. The data were collected using pre-tested and structured questionnaire and eight in-depth interviews were done using an interview guide. The collected data were coded and entered into Epi data 3.5.1 and exported to SPSS version 21 for cleaning and analysis. Logistic regression was run to look for the association between dependent and explanatory variables; and using variables which have p-value ≤0.25 binary logistic regression was fitted. Association presented in Odds ratio with 95% confidence interval and significance determined at P-value less than 0.05.ResultA total of 410 subjects were participated with a response rate of 96.7%. The overall utilization of Preconception care was 13.4%. Woman’s age, marital status, knowledge and availability of unit for preconception care were significantly associated with utilization of preconception care with (AOR: 3.567; 95% CI: 1.082, 11.758), (AOR: 0.062; 95% CI: 0.007, 0.585), (AOR = 6.263; 95% CI: 2.855, 13.739) and AOR: 13.938; 95% CI: 3.516, 55.251) respectively.ConclusionsThe finding of this study showed that women’s utilization of preconception care is relatively low. A woman’s age, marital status, educational status, knowledge about preconception care services and availability of unit for preconception care were factors affecting utilization of preconception care. Therefore, establishing preconception care strategies which can address all the components of the care will be essential when designing effective implementation strategies for improving the uptake of preconception care.

Preconception care and contraception services: Opportunities for community pharmacists

AbstractThere are multiple opportunities for community pharmacists to take on greater roles in the delivery of preconception care and contraceptive services, and pharmacists have indicated interest in developing and expanding such services. Therefore, the objective of this review is to summarize published literature related to community pharmacists' provision of preconception care and contraceptive interventions to help guide related service development and raise awareness about potential opportunities to further expand and integrate such services into practice. Two searches were performed on February 5, 2019 of Medline, Academic Search Complete, and the International Pharmaceutical Abstracts databases from database inception to December 31, 2018. The first search utilized the terms [([contraception or birth control or family planning or contraceptive] OR contraception education OR contraceptives OR contraceptive access) AND ([pharmacists or pharmacist] OR pharmacy OR community pharmacy OR community pharmacist)]; the second search utilized the terms [(preconception OR preconception care OR preconception counseling OR preconception health OR [“preconception care” or “pre‐pregnancy care” or “prepregnancy care”]) AND ([pharmacists or pharmacist] OR pharmacy OR community pharmacy OR community pharmacist)]. Inclusion criteria for the review were articles written in English describing a community pharmacist‐delivered service in the United States. Six articles detailed community pharmacists' roles in contraception, including prescribing hormonal and emergency contraception and administration of injectable contraception. Each study found high rates of patient uptake and satisfaction with these services. One article detailed community pharmacists' provision of preconception care services; again, there was rapid uptake of the service. These articles together highlighted the logistical ease, economic viability, and patient acceptance of such services. Opportunities to expand and integrate these services exist. Published data show that community pharmacists have demonstrated provision of contraceptive and preconception care services in the US, and opportunities exist to grow these programs.

Preconception Care in the Veterans Health Administration.

Preconception care (PCC), defined as a set of interventions to help women optimize their health and well-being prior to pregnancy, can improve pregnancy outcomes and is recommended by national organizations including the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists. Women Veterans who use the Department of Veterans Affairs (VA) health care system may face elevated risks of adverse pregnancy and birth outcomes due to a high prevalence of chronic medical and mental health conditions as well as psychosocial stressors including sexual trauma history and intimate partner violence. Many women Veterans of childbearing age experience poverty and homelessness, which are key social determinants of poor reproductive health outcomes. Furthermore, racial/ethnic disparities in maternal and neonatal outcomes are well documented, and nearly half of women Veterans of reproductive age are minority race/ethnicity. High-quality, equitable, patient-centered PCC services to address modifiable risks in this population are therefore a priority for VA. In this article, we provide a brief background of PCC, discuss the health risks of Veterans associated with adverse pregnancy outcomes, and highlight VA initiatives related to PCC. Lastly, we discuss implications and future directions for PCC research and policy within VA and across other health systems.

Models of HIV Preconception Care and Key Elements Influencing These Services: Findings from Healthcare Providers in Seven US Cities.

Preconception care can improve maternal and infant outcomes by identifying and modifying health risks before pregnancy and reducing unplanned pregnancies. However, information about how preconception care is provided to persons living with HIV (PLWH) is lacking. This study uses qualitative interviews with HIV care providers to describe current models of preconception care and explore factors influencing services. Single, anonymous, telephone interviews were conducted with 92 purposively selected HIV healthcare providers in Atlanta, Baltimore, Houston, Kansas City, Newark, Philadelphia, and San Francisco in 2013–2014. Content analysis and a grounded theory approach were used to analyze data. Participants included 57% physicians with a median of 10 [interquartile range (IQR) = 5–17] years HIV care experience; the mean proportion of female patients was 45%. Participants described Individual Provider (48.9%), Team-based (43.2%), and Referral-only (7.6%) models of preconception care, with 63% incorporating referrals outside their clinics. Thematic analysis identified five key elements influencing the provision of preconception care within and across models: consistency of delivery, knowledge and attitudes, clinic characteristics, coordination of care, and referral accessibility. Described models of preconception care reflect the complexity of our healthcare system. Qualitative analysis offers insights about how HIV clinicians provide preconception care and how key elements influence services. However, additional research about the models and outcomes of preconception care services are needed. To improve preconception care for PLWH, research and quality improvement initiatives must utilize available strengths and tackle existing barriers, identified by our study and others, to define and implement effective models of preconception care services.

Pharmacist and student pharmacist perspectives on providing preconception care in the United States

ObjectivesThe primary objective was to assess pharmacist and student pharmacist current involvement and interest in providing preconception care services. Secondary objectives were to assess comfort in providing these services to various subpopulations in addition to training and resource needs. MethodsA cross-sectional online survey was conducted in the United States and its territories from August 26 to October 14, 2016. Pharmacists and student pharmacists were recruited via a Facebook advertisement to participate in a self-administered survey assessing experiences, interest, and comfort in providing preconception care services in addition to training and resource needs. ResultsThree hundred thirty-two responses were included in the final analysis from the United States and its territories. Most respondents were female (72%) and pharmacists (65%). Respondents reported providing preconception care services, from routine immunizations (54%) to sexually transmitted disease (STD) and HIV screening and management (13%). Respondents also expressed strongest interest in providing new services for STD and HIV screening and management (68%) and minimizing risk of medication teratogenicity (62%). Respondents were most comfortable providing services to female adults (88%) and female adolescents (65%) compared with male adults (61%) and male adolescents (32%). Respondents indicated that tools, such as patient medical records (67%), patient educational materials (66%), and clinical guidelines (60%), would facilitate adoption of preconception care services. ConclusionThis study provides the first insights on the involvement, interest, and comfort of pharmacists and student pharmacists in the United States and its territories related to preconception care. Most respondents indicated that they are currently providing or are interested in providing preconception care services. Tools and resources should be developed to facilitate pharmacist provision of preconception care services.

Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria

Preconception care (PCC) is a preventive strategy for maternal and perinatal morbidity and mortality. This study aimed to assess the level of awareness and utilisation of PCC services. A descriptive cross-sectional survey was conducted at a teaching hospital. Interviewer-administered questionnaires were used to extract information. A total of 450 participants responded; 44.2% (190/450) were aware, 31.7% (143/450) had good knowledge, while only 10.3% (46/450) received PCC. Health care providers were the main source of information (77.9%). There was statistically significant correlation between awareness and participants’ level of education (p < .001) and residence (p < .001), as well as between utilisation and education (p < .001), and information from doctors (p < .001). There was a low level of awareness and poor utilisation of PCC, underpinning the need to scale up health education, establishment of functional PCC clinics and formulation of evidence-based guidelines to improve uptake and pregnancy outcome.Impact statementWhat is already known on the subject of the paper? PCC has been known in high-income countries as a prevention-based strategy, which aims at improving obstetric outcomes. However, the level of utilisation in low-income countries like Nigeria is either unknown or far too low.What do this study add? This work has provided local data on PCC; clearly indicating that the awareness and utilisation of PCC services in Abakaliki, Nigeria is very low when compared with other regions of the world, and this was influenced by the socio-demographic factors – particularly education and place of residence (for awareness), and level of education and information from health care providers (for utilisation), thus suggesting that enlightenment and improvement in social infrastructures could improve awareness, access and utilisation of PCC.What are the implications for clinical practice and/or further research? The implications of these findings in low resource settings like ours will include introducing interventions to scaling up health education, universal establishment of functional PCC units and formulation of evidence-based guidelines aimed at improving the uptake of PCC and pregnancy outcome. Further research will also be needed in future to assess the impact of such interventions and how to sustain potential benefits.

Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

Correlates of Preconception Care among Mothers Prone to Hypertensive Disorders in Nairobi City County

Improved uptake of preconception care has been associated with reduced rates of maternal mortality yet the awareness and uptake of preconception care services among pregnant women, and healthcare teams remain low. This study assessed the awareness of preconception care among pregnant mothers with hypertensive disorders, to examine the influence of male partners in seeking of preconception care and to determine the perceived effects of lack of pre-conception care among pregnant mothers with hypertensive disorders. This was a cross-sectional study in which a sample of 325 mothers seeking ante-natal care was selected from Mbagathi District Hospital, Pumwani Maternity Hospital and Langata Health Centre respectively. A stratified proportionate sampling was used to select the 325 mothers from the three health facilities. Structured questionnaires were used in data collection. Descriptive statistics (mean, median, frequency) were used in analyzing characteristics of the sample. Inferential statistics (Chi-square) was used to test for the relationship between the study variables and seeking of pre-conception care. A p-value of 0.05 was considered significant at a 95% confidence level. A majority of respondents n=232 indicated that preconception care consists of advice prior to conception, medical care during pregnancy and receiving ante-natal care. Health workers at 63% (n=174) were the main source of information on pre-conception care. 72.5% of the respondents had discussed a joint pre-conception care with their male partner. About 27.5% of the respondents had not discussed a pre-conception care plan with their male partners with the leading reason being that partners did not see the reason to accompany their wives for pre-conception care. Marital status at p=0.000 (c 2 = 25.365, df=4), education at p=0.048(c 2 = 18.465, df=10), discussing and making joint plans with partner on pre-conception care at p=0.008 (c 2 = 9.782, df=2) significantly influenced decision to attend pre-conception care. 44.67 % (n=130) of respondents indicated that lack of pre-conception care increases the risk of hypertension disorder causing miscarriage. Twenty-eight percent (n=80) of the respondents indicated that lack of pre-conception care exposes a mother to birth complications that develop due pre-eclampsia. This study identified views of mothers on the uptake of pre-conception care. Perceived lack of time and lack of interest among men were the main barriers that hindered male partners from accompanying their female partners for pre-conception care. Factors that promoted uptake of pre-conception care included, being married, discussing a joint plan with a male partner and having a higher level of education. This study highlights the need for health promotion activities to encourage the need of preparing for pregnancy in the general population. In this regard, health care workers should incorporate health messages on preconception care during ante-natal, immunization and post-natal care sessions to increase awareness on the importance of preconception care.